Effects and safety of massage therapy for patients with metatarsal pain: A protocol for systematic review and meta-analysis.

BACKGROUND: Metatarsalgia refers to localized or generalized forefoot pain in the region of the metatarsal heads. Often this pain is plantar, beneath the metatarsal heads, and arises from either mechanical or iatrogenic causes. The treatment of metatarsalgia remains controversial. A thorough understanding of the biomechanics of the forefoot and the underlying pathology of the particular type of metatarsalgia affecting the patient is a prerequisite to selecting the proper treatment. In recent years, massage therapy has been increasingly accepted by patients due to its lower costs, fewer unwanted side effects, and safety for clinical use. In this systematic review, we aim to evaluate the effectiveness and safety of massage therapy for patients with metatarsal pain. METHODS: We will search the following electronic databases for randomized controlled trials to evaluate the effectiveness and safety of massage therapy in treating metatarsal pain: Wanfang and PubMed Database, CNKI, CENTRAL, CINAHL, and EMBASE. Each database will be searched from inception to October 2020. The entire process will include study selection, data extraction, risk of bias assessment, and meta-analyses. RESULTS: This proposed study will evaluate the effectiveness and safety of massage therapy for patients with metatarsal pain. The outcomes will include changes in metatarsal pain relief and adverse effect. CONCLUSIONS: This proposed systematic review will evaluate the existing evidence on the effectiveness and safety of massage therapy for patients with metatarsalgia. DISSEMINATION AND ETHICS: The results of this review will be disseminated through peer-reviewed publication. Because all of the data used in this systematic review and meta-analysis has been published, this review does not require ethical approval. Furthermore, all data will be analyzed anonymously during the review process. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/C6KFJ.

Common Foot Problems: Over-the-Counter Treatments and Home Care.

Most foot disorders do not require podiatry referral or complex interventions. After the clinical diagnosis is made, these conditions can typically be managed with over-the-counter (OTC) and home remedies, with guidance from the primary care physician. Stretching and strengthening exercises, along with the use of heel cups, resolve most plantar fasciitis cases and are at least as effective as nonsteroidal anti-inflammatory drugs or steroid injections. Hallux rigidus is best managed with a hard-soled shoe or rigid insert that relieves pain by restricting motion across the metatarsophalangeal joint. Hallux valgus responds to use of wide toe box shoes, and surgery is not clearly beneficial beyond one year. Plantar warts can be treated effectively at home with OTC salicylic acid and cryotherapy topical agents, which have equal effectiveness to liquid nitrogen. In patients with corns and calluses, OTC topical salicylic acid has short-term benefits, and pads and inserts that more evenly redistribute contact forces have long-term benefits. Inserts are commonly recommended to redistribute forefoot pressure and relieve pain. Several OTC preparations are available for the treatment of tinea pedis, with topical allylamines being the most effective. Although OTC topical treatments have been widely used for onychomycosis, they have poor long-term cure rates compared with prescription oral medications.

Effect of magnetic vs sham-magnetic insoles on nonspecific foot pain in the workplace: a randomized, double-blind, placebo-controlled trial.

OBJECTIVE: To determine whether magnetic insoles are effective for relieving nonspecific subjective foot pain in the workplace, resulting in improved job satisfaction. SUBJECTS AND METHODS: A prospective, randomized, double-blind, placebo-controlled study of health care employees who experienced nonspecific foot pain for at least 30 days, which occurred more days than not, was conducted between February 2001 and January 2002 at the Mayo Clinic in Rochester, Minn. Participants were asked to wear either magnetic or sham-magnetic cushioned insoles for at least 4 hours daily, 4 days per week for 8 weeks. The primary outcome variable was reported foot pain (by categorical response of change from baseline and by visual analog scale) at 4 and 8 weeks. Secondary outcome variables included graded intensity of pain experienced during various daily activities and the effect of insoles on job performance and enjoyment. RESULTS: Among 89 enrolled participants, 6 either withdrew before wearing insoles or were noncompliant with follow-up questionnaires; 83 participants remained for full statistical analysis. Participants in both treatment groups reported improvements in foot pain during the study period. No significant differences in categorical response to pain or pain intensity were seen with use of magnetic vs sham-magnetic insoles. CONCLUSIONS: The magnetic insoles used in this study by a heterogeneous population with chronic nonspecific foot pain were not clinically effective. Findings confirmed that nonspecific foot pain significantly interferes with some employees' ability to enjoy their jobs and that treatment of that pain improves job satisfaction.